Alcohol consumption and the related health effects are a major problem in New Mexico where alcohol is the leading cause of death in people under age 65. New Mexico has the highest rate of alcohol-related death in the country and the statewide rate of alcohol-involved traffic crashes is more than twice the national rate. The goal of this project is to translate motivational interventions that have been successful in the primary care setting to the University Hospital Emergency Department (Albuquerque, NM) by implementing screening, brief intervention and referral to treatment (SBIRT) in order to reduce hazardous drinking among emergency department patients. Specifically, the project will introduce a formal SBIRT program in the University Hospital Emergency Department (UH - ED) to identify problem alcohol use among ED patients, use the publicity generated by National Alcohol Screening Day (NASD) to enhance adoption of SBIRT by ED personnel (physicians, physician assistants, and nurses) and reduce the reoccurrence of problem drinking among ED patients by providing referral to treatment resources. The project will consist of a case/control study to examine the effects of a motivational brief intervention presented by ED personnel to patients who screen positive for problem drinking. Patients will be screened for at-risk drinking at the time of their presentation to the ED, and case patients will be offered a brief intervention and referral for treatment. [unreadable] [unreadable] Control patients will be given only a written list of service providers. All patients will receive follow-up contact by phone 3 and 6 months later to determine their usage of referral services and their current level of drinking. The project will be conducted in coordination with separately-funded programs which will provide both specific training to ED providers in the techniques of SBIRT, and aggregate data analysis from multiple intervention sites across the country. Using standardized screening and follow-up questions from all sites, the impact of SBIRT in the ED can be compared to the success of SBIRT in the primary care environment. [unreadable] [unreadable]